Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1154698165 |
---|---|
Provider Name | Mrs. Kay L. Weaver |
First Address | Gap, PA 17527 |
Second Address | Gap, PA 17527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2011 |
Last Update Date | 18/11/2011 |